Changes in Use of Family Planning among the Urban Poor: Evidence from Nairobi Slums

Abstract

As urbanization continues unabated in Kenya, the wellbeing of the urban poor ‐ whose majority live in slum settlements ‐ will increasingly drive national development indicators including Vision 2030, SDGs and FP2020 goals. It is therefore central to understand and identify ways to address the poor reproductive health outcomes among poor urban slum populations in the country. Taking advantage of APHRC's NCSS surveys conducted in 2000 and 2012 among a representative sample of slum households across Nairobi, we show that there has been a considerable increase in use of modern contraception among women in Nairobi slums, from 34% in 2000 to 53% in 2012, and a reduction in inequity in access through much higher increases among previously disadvantaged groups. Using decomposition analysis techniques, we show that much of the observed increase is due to behavioral changes in the effect of fertility preferences on contraceptive use; and to compositional changes in woman's education, child survival and exposure to FP information. This may be the result of efforts by the government of Kenya and its development partners to reduce the disparities in uptake and use of FP services through various programs and policies targeting the poor segments of the Kenyan population.

Knowledge and Information Exposure About Family Planning Among Women of Reproductive Age in Informal Settlements of Kira Municipality, Wakiso District, Uganda

“…With a focus on perceived local drivers and barriers, CGE in dialogue and action is a recognized high-impact practice in FP for behavior change that has the promise to improve women's and men's FP knowledge, improve women's decision-making power, and fostering family or social changes (40). Specifically looking at adolescents and young people within urban spaces, they face various FP challenges and play a wide range of roles, including students, laborers, spouses, or parents (41)(42)(43). Besides strengthening the provision of youth-friendly services in marginalized urban areas, the use of benefit cards/vouchers could be used to facilitate equitable access to more contraceptive options through both public and private providers.…”

Determinants of unmet need for family planning among married women of reproductive age in Burundi: a cross-sectional study

“…The association between unmet need and parity was found in many other studies. In Ethiopia, the number of living children was one of the factors affecting the unmet need for limiting [ 20 ] while in Uganda, it affected both the spacing, limiting and the total unmet need [ 22 ].…”

“…Women who lost a child tended to resume reproduction as soon as possible, to replace the loss. To be successful thus, SRH programmes need to be accompanied by efforts aimed at reducing child and infant mortality [ 22 ].…”

Role of Religious Leaders in Promoting Contraceptive Use in Nigeria: Evidence From the Nigerian Urban Reproductive Health Initiative

“…Currently, about 48.6% of Nigeria's population lives in urban areas; and, estimates suggest that by 2050, this will exceed 50%. 36 Evidence shows that the urban poor tend to have more children than the urban non-poor, 37 particularly because they have limited or no access to family planning services.…”